POLICY: Ezra on how to make this time different

Meanwhile, since we’re going on about LA Times op-ed pieces on health care, on Sunday Erza Klein has one somewhat misleadingly titled This time, we want healthcare reform. It’s really a study of what went wrong in 1993–4 and how to not have that happen again. As I was reading it I noticed that Ezra had done his homework over here at THCB, but waas nice enough to say so and drop my name in his piece.

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  1. Ezra Klein engages in revisionist history by asserting that the health insurance industry, for-profit hospital chains, and the other usual suspects were almost solely responsible for the demise of the Clinton reform plan. He neglects to mention that the Clinton proposal infuriated some influential Democrats (such as Senator Daniel Patrick Moynihan) who viewed it as a heavy-handed approach and rather hostile to the interests of academic medical centers. Moreover, Klein fails to acknowledge that some prominent health policy gurus such as Alain Enthoven (a lifelong Democrat) opposed the price-controls and certain other regulatory features of the Clinton proposal. Basically, the Clinton administration took a good idea (managed competition) and destroyed it by adding features which Enthoven and others never advocated.
    Klein also neglects to mention that the United Auto Workers and some other large unions who enjoyed rich health benefits under status quo arrangements were less than thrilled with the Clinton plan, fearing that their members would ultimately be called upon to pay income taxes on a portion of their benefits.